Comparative effectiveness of bariatric surgeries in patients with obesity and type 2 diabetes mellitus: A network meta-analysis of randomized controlled trials
| Autor: | Li Ding, Shaofang Tang, Qing He, Dongwang Qi, Hui Li, Ming Liu, Yuxin Fan, Yalan Zhang, Chuanjun Zhuo, Jingqiu Cui |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Network Meta-Analysis Bariatric Surgery/Obesity Comorbidity Bariatric Surgery 030209 endocrinology & metabolism bariatric surgeries Gastroenterology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Diabetes mellitus Internal medicine medicine Humans network meta‐analysis 030212 general & internal medicine Obesity Randomized Controlled Trials as Topic business.industry Public Health Environmental and Occupational Health Type 2 Diabetes Mellitus Middle Aged medicine.disease Curvatures of the stomach Duodenal switch diabetes remission Blood pressure Treatment Outcome Diabetes Mellitus Type 2 Meta-analysis cardiometabolic outcome Female business |
| Zdroj: | Obesity Reviews |
| ISSN: | 1467-789X |
| Popis: | Summary A network meta‐analysis of randomized controlled trials (RCTs) was performed to determine the hierarchies of different bariatric surgeries in patients with obesity and type 2 diabetes mellitus (T2DM), in terms of diabetes remission and cardiometabolic outcomes. Seventeen RCTs and six bariatric surgeries, including single anastomosis (mini) gastric bypass (mini‐GBP), biliopancreatic diversion without duodenal switch (BPD), laparoscopic‐adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), Roux‐en‐Y gastric bypass (RYGBP), greater curvature plication (GCP) and nonsurgical treatments (NST) were included. Mini‐GBP, BPD, LSG, RYGBP and LAGB (from best to worst), as compared with NST, were all significantly associated with the remission of T2DM. For the follow‐up period > 3 years, BPD, mini‐GBP, RYGBP and LSG (from best to worst) were significantly superior to NST in achieving the remission of T2DM. For secondary outcomes, the overall ranking for bariatric surgeries was RYGBP > BPD > LSG > LAGB after comprehensively weighting glucose, weight, systolic and diastolic pressure, total cholesterol, triglycerides, high‐density lipoprotein cholesterol (HDL‐C) and low‐density lipoprotein cholesterol (LDL‐C). Mini‐GBP has the greatest probability of achieving diabetes remission in adults with obesity and T2DM, yet BPD was the most effective in long‐term diabetes remission. RYGBP appears to be the most favourable alternative treatment to manage patients with cardiometabolic conditions. |
| Databáze: | OpenAIRE |
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